Women may face a higher risk of developing mental health conditions following their type 2 diabetes diagnosis than men, a new study has found. Researchers at Queen Mary University, London, found that around 8 percent of women involved in the study went on to experience a mental health condition, including depression and anxiety, after their diagnosis compared to 5 percent of men. They also observed that people with type 2 diabetes and a diagnosis of anxiety, depression or somatoform disorder had the "earliest deaths in both sexes in our data, which makes it worth treating as a red flag worth investigating further, rather than a proven mechanism," Fabiola Eto, study lead and research associate at Queen Mary University, told Newsweek.
Eto said plausible reasons for this could include "it can make it harder to stick with medication, monitor blood sugar, or attend appointments; it may reflect broader struggles with self-care; and in men specifically, it may go along with lower engagement with healthcare generally." Men were instead more likely to be diagnosed with cardiovascular disease and kidney disease, which Eto said could be because estrogen "may offer women some protection against heart disease before menopause," and testosterone "may speed up kidney damage in men with diabetes." The researchers followed almost 29,000 people newly diagnosed with type 2 diabetes between 2010 and 2020. The study was published in the journal PLOS Medicine in August. Eto said the data suggests for women, and especially younger women aged 16 to 39, a mental health condition "tends to be one of the earliest things to emerge after a type 2 diabetes diagnosis, sometimes before any physical complication shows up at all." "That's a different lived experience than the one diabetes care is often built around, which tends to focus first on blood sugar, weight, and cardiovascular risk," she said.
"For a younger woman, being told she has a lifelong metabolic condition at an age when it's still uncommon may carry a particular psychological weight, on top of everything else diabetes management demands day to day." While the findings add to pre-existing research showing a "bi-directional association between type 2 diabetes and certain mental health conditions," it is important to note that it did not directly "assess whether type 2 diabetes caused mental health problems," Elizabeth Beverly, a professor of behavioral diabetes at Ohio University, who was not involved in the study, told Newsweek. This bi-directional association means that while people with type 2 diabetes are more likely to have depression, those with depression may also be more likely to have type 2 diabetes, Jeffrey Gonzalez, a professor of psychology at Yeshiva University, who was not involved in the study, told Newsweek. Previous studies, such as one 2023 review published in the Lancet, have established that those with diabetes experience higher rates of mental health problems than the general population, which can include fear of hypoglycaemia (low blood sugar), diabetes distress, depression, disordered eating, and sleep disorders.
Beverly said that the "daily demands of managing diabetes, including taking medications, monitoring glucose levels, eating healthy foods, engaging in regular physical activity, attending medical appointments, and worrying about complications, can contribute to frustration, emotional exhaustion, and feeling discouraged." She also said that for many people additional stresses like "food insecurity, lack of transportation, housing instability, financial pressures, unemployment, and lack of access to specialty care compound these burdens," and for those working full-time and simultaneously managing the needs of their children, spouses, and older relatives, one's own health can become "last on their list of priorities." She added that over time, this "emotional burden can lead to depression and/or anxiety, both of which make it more difficult to carry out self-management behaviors and achieve glycemic goals." "This is a tough disease, and there is great deal of stigma that surrounds it," William Polonsky, president of the Behavioral Diabetes Institute, who was not involved in the study, told Newsweek. Why more women than men seem to develop mental health conditions following a type 2 diabetes diagnosis is not yet known. Gonzalez said that one reason could be simply down to the fact that anxiety and depression are "much more common among women than men, irrespective of diabetes." "The relative proportion of the burden of depression in women with diabetes compared to men mirrors the large epidemiologic evidence of the burden of depression in women in the general population," Mary de Groot, a professor of medicine at Indiana University, who was not involved in the study, told Newsweek.
Men were also found to be less likely use health care services, which could have influenced the data, as greater "contact with the health care systems creates more opportunities to discuss, recognize, and document mental health conditions," Beverly said. "It is possible that the men in this study were less likely to seek care or disclose symptoms of depression, anxiety, or somatization." Polonsky also said that while women score higher than men on questionnaires about depression, anxiety and other mental health problems, this difference may "simply indicate that women are more comfortable than men in acknowledging these tough emotions," adding that men "tend to suffer more silently." Beverly said that psychosocial care "should be integrated into routine diabetes care," and that health care professionals should "screen for diabetes distress, depression, and anxiety at least annually, according to clinical recommendations, and ensure that positive screens lead to expanded assessment and evidence-based treatment." Gonzalez said the findings "underscore the clinical importance of understanding this link by showing that the emergence
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